Ektopik Gebelik Olgularında Methotrexatın Tedavi Etkinliğinin Değerlendirilmesi

Aim: Our aim in this study was to assess efficacy of singledose methotrexate (MTX) as medical treatment for ectopic pregnancy (EP) by evaluating the results of patients given this treatment. Materials and Methods: Between September 2016 and August 2017, the treatment outcomes of EP cases treated with MTX at Gazi Yaşargil Training and Research Hospital of Health Sciences University were evaluated retrospectively. Results: In total, 126 cases treated for EP were evaluated and 65 cases were included in the study. In cases administered a single dose of MTX, the success rate was 80%, the failure rate was 13.8%, and the emergency surgery rate was 6.2%. The overall success rate of the medical treatment was 90.7% for a second dose of MTX. An unsuccessful result was considered as less than a 15% reduction in the beta-human chorionic gonadotropin (?-hCG) level between 4 and 7 days after single dose MTX administration. In all cases, the rate of emergency surgery after treatment was 9.3%. Conclusions: In our study, success rates in patients with EP treated with MTX were 80% after a single dose and as high as 90.7% when a second dose was addedAmaç: Bu çalışmadaki amacımız ektopik gebelik’ te (EP) medikal tedavi olarak tek doz methotrexat (MTX) tedavisi verilen olguların sonuçlarının değerlendirilmesidir. Materyal ve Metot: Eylül 2016 ile Ağustos 2017 arasında Sağlık Bilimleri Üniversitesi Gazi Yaşargil Eğitim ve Araştırma Hastanesinde tedavi edilen EP olgularında MTX tedavisi uygulanmış olanların tedavi sonuçları retrospektif olarak değerlendirildi. Bulgular: Çalışmanın yapıldığı tarihler arasında EP nedeniyle tedavi edilen 126 olgu çalışmaya dahil edildi. Tek doz MTX tedavisi başlanan olgularda başarı oranı %80, başarısızlık %13.8 ve acil cerrahi oranı %6.2 olarak gerçekleşti. Tek doz MTX uygulaması sonrasında 4 ve 7 günler arsında betahuman chorionic gonadotropin (?-hCG) seviyesinin %15 ten az düşmesi sonucunda başarısız olarak kabul edilen olgularda yapılan 2. doz MTX sonucunda, medikal tedavinin toplam başarı oranı %90.7 olarak gerçekleşirken, bu olguların tümünde tedavi sonrası acil cerrahi oranı %9.3 olarak gerçekleşti. Sonuç: Çalışmamızda uygun endikasyonla MTX tedavisi uygulanan EP olgularında medikal tedavinin başarı oranı %90.7 gibi oldukça yüksek bir oranda gerçekleşmiş olup olguların sadece %9.3 de MTX tedavisi sonrasında acil cerrahi tedavi gerekmiştir

The Effect of Seasonal Temperature Changes on Gestational Diabetes Mellitus Prevalence

Aim:The aim of this study was to investigate the effect of seasonal changes in ambient temperature on the prevalence of gestational diabetes mellitus (GDM).Materials and Methods:A retrospective evaluation was performed on the results of patients at 24-28 weeks gestation who underwent a GDM screening at the University of Health Sciences Turkey, Gazi Yaşargil Training and Research Hospital in Diyarbakır, which is a city that is warm and dry in summer and cold and rainy in winter, between January 2017 and December 2017. Pregnant women were divided into four groups according to the season they were screened for GDM. A comparison was made in terms of the prevalence of GDM among pregnant women screened for diagnosis of GDM in different seasons.Results:Of 3,618 pregnant women screened, 7.5% (n=272) were diagnosed with GDM. The seasonal distribution of the GDM cases was 6.4% (n=54) in winter, 8.3% (n=78) in spring, 9.2% (n=84) in summer, and 6.1% (n=56) in autumn. A significant difference was observed in terms of seasonal distribution (p<0.05).Conclusion:The results of this study have demonstrated that seasonal temperature changes have a significant effect on GDM prevalence. However, further studies are needed to better demonstrate this relationship

Maternal serum IL-22 concentrations are significantly upregulated in patients with preterm premature rupture of membranes

Objectives: This study aimed to compare the serum IL-22 levels between preterm premature rupture of membranes (PPROM) patients and the control group with intact membranes. We also hypothesized whether serum IL-22 upregulation might contribute to defense against inflammatory responses and improve the pregnancy outcomes.Material and methods: We performed this prospective case-control study between 24–34 weeks of pregnancy. We enrolled 40 singleton pregnant patients with PPROM and 40 healthy gestational age- and gravidity-matched patients without PPROM. The degree of association between variables and IL-22 were calculated by Spearman correlation coefficients where appropriate. Scatter plots were given for statistically significant correlations. ROC curve was constructed to illustrate the sensitivity and specificity performance characteristics of IL-22, and a cutoff value was estimated by using the index of Youden.Results: Maternal serum IL-22 levels were significantly higher in PPROM patients (60.34 ± 139.81 pg/mL) compared to the participants in the control group (20.71 ± 4.36 pg/mL, p &lt; 0.001). When we analyze the area under the ROC curve (AUC), the IL-22 value can be considered a statistically significant parameter for diagnosing PPROM. According to the Youden index, a 23.86 pg/mL cut-off value of IL-22 can be used to diagnosing PPROM with 72% sensitivity and 61.5% specificity. There was no positive correlation between serum IL-22 levels and maternal C-reactive protein (CRP) value, procalcitonin value, latency period, birth week, birth weight, and umbilical cord blood pH value.Conclusions: Maternal serum IL-22 levels were significantly higher in PPROM patients than healthy pregnant women with an intact membrane. We suggest that IL-22 might be a crucial biomarker of the inflammatory process in PPROM

Des boîtes à pilules en béton

Julien Pierre. Des boîtes à pilules en béton. In: Revue d'histoire de la pharmacie, 82ᵉ année, n°302, 1994. p. 317